PM 06-05-02: Program Requirements

To receive emergency medical benefits, ineligible noncitizens must need, or have received, emergency medical services during the month of application or during the 3 months before the month of application.

An emergency condition:

occurs suddenly and unexpectedly,

is caused by injury or illness,

has acute and severe symptoms, such as pain, and

requires immediate medical attention to prevent:

jeopardy to patient's health, or

serious impairment to bodily functions or parts.

NOTE: Services provided in a hospital emergency room must meet the criteria.

Terminal illness or the need for long term care services alone does not qualify the
person for emergency medical coverage. The person must also have an emergency medical condition as defined above.

Benefits for emergency labor and delivery should be authorized under the Family Assist, FamilyCare Assist or
Moms & Babies programs, not Emergency Medical for Ineligible Noncitizens.

The applicant's doctor must verify the emergency in writing.

Emergency medical is provided only until the condition that caused the emergency stabilizes and there are no longer acute symptoms.

Ineligible noncitizens must also meet the requirements for:

residence (a visa is not relevant to determining residence);

institutional status;

blind, disabled, or age 65 and over (AABD Medical Only);

age, relationship, and living with (Assist);

medical support rights;

client cooperation;

assets (AABD Medical Only);

income;

support from a responsible relative;

personal injury awards; and

third party liability.

Ineligible noncitizens are not required to meet the following program requirements: